Californians must look at science of marijuana

PROPOSITION 19 / Regulate, Control and Tax Cannabis Act

Published 4:00 am, Sunday, August 22, 2010

Photo: Brant Ward, The Chronicle 2007

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Photo: Brant Ward, The Chronicle 2007

Californians must look at science of marijuana

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Like so many political debates in our society, the argument over Proposition 19, the initiative to legalize marijuana in California, is portrayed as good vs. evil, black vs. white, us vs. them - while nobody is looking objectively at the medical science of marijuana. If research does enter the debate, each side touts the scientific bits that bolster its arguments and then ignores the rest.

The California Society of Addiction Medicine is in a unique position: We take no position on Prop. 19, but we wish Californians would look at the research before they make up their minds on how to vote.

We are the doctors who specialize in the treatment of drug abuse; we work every day with people addicted to drugs, including alcohol. We are a diverse group of doctors committed to combining science and compassion to treat our patients, support their families and educate public policy makers.

Less than one-third of the Society of Addiction Medicine's 400 physician members believe prison deters substance abuse. Most believe addiction can be remedied more effectively by the universal availability of treatment. When, according to the FBI, nearly half - 750,000 - of all drug arrests in 2008 in the United States were for marijuana possession, not sales or trafficking, we risk inflicting more harm on society than benefit. Prop. 19 does offer a way out of these ineffective drug policies.

However, two-thirds of our members believe legalizing marijuana would increase addiction and increase marijuana's availability to adolescents and children. A recent Rand Corp. study estimates that Prop. 19 would produce a 58 percent increase in annual marijuana consumption in California, raising the number of individuals meeting clinical criteria for marijuana abuse or dependence by 305,000, to a total of 830,000.

The question of legalizing marijuana creates a conflict between protecting civil liberties and promoting public health, between desire and prudence, between current de facto legalization in cannabis clubs and revenue-generating retail marijuana sales.

Each individual, family, politician and community must struggle with these competing agendas in making a decision about whether marijuana should be legal. The society wants to make sure voters understand three basic facts about how marijuana affects the brain:

-- The brain has a natural cannabinoid system that regulates human physiology. The flood of cannabinoids in marijuana smoke alters the brain's delicate balance by mimicking its chemistry, producing a characteristic "high" along with a host of potential side effects.

-- Marijuana is addicting to 9 percent of people who begin smoking at 18 years or older. Withdrawal symptoms - irritability, anxiety, sleep disturbances - often contribute to relapse.

-- Because adolescent brains are still developing, marijuana use before 18 results in higher rates of addiction - up to 17 percent within two years - and disruption to an individual's life. The younger the use, the greater the risk.

Marijuana is a mood-altering drug that causes dependency when used frequently in high doses, especially in children and adolescents. It's important that prevention measures focus on discouraging young people from using marijuana.

Prop. 19 erroneously states that marijuana "is not physically addictive." This myth has been scientifically proven to be untrue. Prop. 19 asks Californians to officially accept this myth. Public health policy already permits some addictive substances to be legal - for instance, alcohol, nicotine and caffeine. But good policy can never be made on a foundation of ignorance. Multiple lines of scientific evidence all prove that chronic marijuana use causes addiction in a significant minority of people. No one should deny this scientific evidence.

Physicians see many people who seek help in quitting marijuana. If Californians decide to legalize marijuana, who will pay for the additional treatments that will be needed? This question becomes profoundly more relevant if your own child has become devoted to smoking pot. If marijuana is legalized, a truly fair, socially just public policy would use tax revenue from marijuana sales to pay for increased treatments.

The Society of Addiction Medicine strongly recommends that, if marijuana is legalized, restrictions must minimize access for anyone under 21, and a tax on revenues must be directed to treatment.

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